Motion For Referral To General Magistrate - Florida Circuit Court Page 4
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9_________________________________
Signature of Party or his/her attorney:
Printed Name: ______________________
Address: ___________________________
City, State, Zip:______________________
Telephone Number:__________________
Fax Number:________________________
Email Address(es):__________________
Florida Bar Number:________________
IF A NONLAWYER HELPED YOU FILL OUT THIS FORM, HE/SHE MUST FILL IN THE BLANKS BELOW:
[fill in all blanks] This form was prepared for the: {choose only one} (
) Petitioner ( ) Respondent
This form was completed with the assistance of:
{name of individual}____________________________________,
{name of business} ____________________________________________________________________,
{address}
_______________________________,
{city}
_____________________,{state}
_________, {telephone number} __________________.
Florida Family Law Rules of Procedure Form 12.920(a), Motion for Referral to General Magistrate ( 09/12)
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